401k Plan data: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN plan

ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 401k Plan overview

Plan Name	ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN
Plan identification number	001

ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ST. PAUL HEALTH CENTER has sponsored the creation of one or more 401k plans.

Company Name: ST. PAUL HEALTH CENTER

Employer identification number (EIN): 840975965

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 MARK BEDINGER
001 2010-01-01 MARK BEDINGER
001 2009-01-01 MARK BEDINGER
001 2009-01-01 MARK BEDINGER

Plan id#	Filing Submission Date	Name of Administrator
001	2011-01-01	MARK BEDINGER
001	2010-01-01	MARK BEDINGER
001	2009-01-01	MARK BEDINGER
001	2009-01-01	MARK BEDINGER

Plan Statistics for ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN

401k plan membership statisitcs for ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN

Measure Date Value
2011: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 336
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 241
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 115
Total of all active and inactive participants 2011-01-01 356
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 356
Number of participants with account balances 2011-01-01 245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 6
2010: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 295
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 188
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 108
Total of all active and inactive participants 2010-01-01 296
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 296
Number of participants with account balances 2010-01-01 258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 6
2009: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 227
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 176
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 86
Total of all active and inactive participants 2009-01-01 262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 262
Number of participants with account balances 2009-01-01 157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2011: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	336
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	241
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	115
Total of all active and inactive participants	2011-01-01	356
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	356
Number of participants with account balances	2011-01-01	245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	6
2010: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	295
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	188
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	108
Total of all active and inactive participants	2010-01-01	296
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	296
Number of participants with account balances	2010-01-01	258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	6
2009: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	227
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	176
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	86
Total of all active and inactive participants	2009-01-01	262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	262
Number of participants with account balances	2009-01-01	157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN

Measure	Date	Value
2011 : ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$4,115
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$951
Total income from all sources (including contributions)	2011-12-31	$123,208
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$43,417
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$37,128
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$122,739
Value of total assets at end of year	2011-12-31	$767,671
Value of total assets at beginning of year	2011-12-31	$684,716
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$6,289
Total interest from all sources	2011-12-31	$6,698
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$6,289
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$100,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$95,291
Participant contributions at end of year	2011-12-31	$10,526
Participant contributions at beginning of year	2011-12-31	$5,807
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$3,391
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$1,926
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$951
Other income not declared elsewhere	2011-12-31	$13,187
Liabilities. Value of operating payables at end of year	2011-12-31	$4,115
Liabilities. Value of operating payables at beginning of year	2011-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$79,791
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$763,556
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$683,765
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$443,761
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$413,139
Interest on participant loans	2011-12-31	$519
Interest earned on other investments	2011-12-31	$6,179
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$309,993
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$263,844
Net investment gain/loss from pooled separate accounts	2011-12-31	$-19,416
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$27,448
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$37,128
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	ANTON COLLINS MITCHELL LLP
Accountancy firm EIN	2011-12-31	010724563
2010 : ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$951
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$2,176
Total income from all sources (including contributions)	2010-12-31	$179,712
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$111,160
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$103,539
Expenses. Certain deemed distributions of participant loans	2010-12-31	$3,500
Value of total corrective distributions	2010-12-31	$2,686
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$126,990
Value of total assets at end of year	2010-12-31	$684,716
Value of total assets at beginning of year	2010-12-31	$617,389
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$1,435
Total interest from all sources	2010-12-31	$5,996
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$1,435
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$100,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$99,905
Participant contributions at end of year	2010-12-31	$5,807
Participant contributions at beginning of year	2010-12-31	$9,016
Participant contributions at end of year	2010-12-31	$0
Participant contributions at beginning of year	2010-12-31	$2,880
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$2,109
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$1,926
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$1,926
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$951
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$2,176
Other income not declared elsewhere	2010-12-31	$3,213
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$68,552
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$683,765
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$615,213
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$413,139
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$408,566
Interest on participant loans	2010-12-31	$504
Interest earned on other investments	2010-12-31	$5,492
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$263,844
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$194,236
Net investment gain/loss from pooled separate accounts	2010-12-31	$43,513
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$24,976
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$765
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$103,539
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	ANTON COLLINS MITCHELL LLP
Accountancy firm EIN	2010-12-31	010724563
2009 : ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN

2011: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: ST. PAUL HEALTH CENTER 401K RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	ST. PAUL HEALTH CENTER
Employer identification number (EIN):	840975965
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities